Advanced Management Options for Endometriosis

Abstract

Endometriosis is a benign disease affecting 10 % of reproductive age females. Approximately 35% of women with this condition are infertile. The exact cause of the disease is still unknown, but advances in human and animal research have further elaborated its pathogenesis. Conventional, non-fertility related treatment for endometriosis focuses on chronic pelvic pain, which is the most common manifestation of this disease. While traditional methods of treatment have not proven to be completely effective, both medical and surgical therapies still hold some promise in controlling pain. Empiric medical therapy is still the most common mode for initiating treatment. Controversies exist regarding fertility outcomes after surgical treatment. Assisted reproduction holds promise in patients with advanced endometriosis. New treatment options have arisen in response to advances in research targeting the pathogenesis of the disease. Most of the newer therapies are still experimental, but results in animal models show promise, which has served as an impetus for conducting human trials. This article will focus on these new treatment options for endometriosis while also briefly describing the pathogenesis, diagnosis and controversies of existing treatment modalities. Keywords: Endometriosis, infertility, angiogenesis, matrix metalloproteinase, SPRM, cytokine, IVF